When Policy Topic is covered Metal-on-metal total hip resurfacing with a device system approved by the U.S. Food and Drug Administration (FDA) may be considered medically necessary as an alternative to total hip replacement when the patient:  Is a candidate for total hip replacement; AND  Is likely to outlive a traditional prosthesis; AND  Does not have a contraindication for total hip resur...

Juvenile idiopathic arthritis is the leading cause of hip replacement in young children. However, arthroplasty in this population is challenging with several concerns about quality of the growing bone, young age for revision surgery, and difficulties in potential several revisions. In this study we introduce a case of a 12-year old who is one of the youngest patients to undergo revision hip art...

Between 2001 and 2011, 1168 revision hip arthroplasties were reviewed for "early" failures within 5 years of the primary total hip arthroplasty (THA). 24.1% underwent revision within 5 years of index THA. Aseptic loosening, infection, instability, metallosis, and fracture were common modes of failure. In our previous report from 1986 to 2000, 33% were "early" revisions, with instability and ase...

Given the increasing number of total hip arthroplasty procedures being performed annually, it is imperative that orthopaedic surgeons understand factors responsible for instability. In order to treat this potentially complex problem, we recommend correctly classifying the type of instability present based on component position, abductor function, impingement, and polyethylene wear. Correct clas...

BACKGROUND A discrepancy in leg length and femoral offset restoration is the leading cause of patient dissatisfaction in hip replacement surgery and has profound implications on patient quality of life. The aim of this study is to compare biomechanical hip reconstruction in hip resurfacing, large-diameter femoral head hip arthroplasty and conventional total hip replacement. METHOD Sixty patie...

BACKGROUND Primary total hip arthroplasty leads to better functional capacities but a general weakness of abductor muscles often persists. A larger head component may improve the postural balance in the medial-lateral direction. The aims of this study are (1) to compare postural stability in patients after total hip and surface replacement arthroplasties and (2) to evaluate the effect of the bi...

OBJECTIVES To summarise epidemiological data on the frequency of hip replacements in the countries of the developed world, especially in countries of the Organisation for Economic Cooperation and Development (OECD), and to investigate whether missing consensus criteria for the indication for total hip replacement (THR) result in different replacement rates. METHODS Country-specific hip replac...

The purpose of this study was to examine the complications and outcomes of total hip replacement (THR) in super-obese patients (body mass index (BMI) > 50 kg/m(2)) compared with class I obese (BMI 30 to 34.9 kg/m(2)) and normal-weight patients (BMI 18.5 to 24.9 kg/m(2)), as defined by the World Health Organization. A total of 39 THRs were performed in 30 super-obese patients with a mean age of ...

BACKGROUND Concerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients? METHODS Details of sexual activity an...